2008 HAMPTON YACHT CLUB
SPRING
JUNIOR PROGRAM APPLICATION FORM
BACK
Please return this completed application and waiver form for each child along with a check for the fees to:
CHAIRMAN, JUNIOR ADVISORY COMMITTEE
HAMPTON YACHT CLUB
4707 VICTORIA BLVD.
HAMPTON, VA 23669
MAKE CHECKS PAYABLE TO THE : HYC JUNIOR PROGRAM.
Please use this application form by printing it out. If you wish additional forms are available at the Club.
Program enrollment is not limited to yacht club members, so if you know of a boy or girl who wants to sail/race please print out this form or call the Hampton Yacht Club for extra applications.
| APPLICANT'S NAME (PRINT) | SEX | BIRTH DATE |
| _________________________________________ | ___FEMALE ___MALE | ____________ |
| PARENT/GUARDIAN (PRINT) | HYC MEMBER # ((CLUB MEMBERS MAY CHARGE THIS FEE) |
| ___________________________________________________ | _________________________ |
|
| MAILING ADDRESS (PRINT) |
| name__________________________________________________________________________
street__________________________________________________________________________ city, state _____________________________________ zipcode____________________ |
| CONTACT PHONE NUMBERS | MOBILE EMERGENCY NUMBER | |
| HOME __________________ | WORK ______________ | CELL, BEEPER, PAGER _________________ |
| EMAIL ADDRESS:_______________________________ |
PLEASE NOTE: This is not a "Learn to Sail" program. All applicants must know, as a minimum, the basics of sailing. The Head Instructor may limit participation based on skill level.
I fully understand the conditions under which this application is made, and give my permission for his/her participation in the Junior activities of the Hampton Yacht Club. I certify as to the ability of the applicant to jump overboard in deep water and swim at least 50 yards and tread water for five minutes. I hereby assume financial responsibility on behalf of the applicant.
Signature (PARENT/GUARDIAN) _________________________________ DATE __________
RELEASE FORMS MUST ALSO BE SIGNED AND ACCOMPANY THIS APPLICATION TO ALLOW PARTICIPATION.